Immunologic-based Diagnosis of Latent Tuberculosis Among Children Younger Than 5 Years of Age Exposed and Unexposed to Tuberculosis in Tanzania
Autor: | Christian Schindler, Khadija Said, Mwajabu Ruzegea, Nicole Ritz, Karim Manji, Francis Mhimbira, Jürg Utzinger, Jerry Hella, Marcel Tanner, Magreth Chiryamkubi, Anna M. Mandalakas, Rajesh Solanki, Lukas Fenner |
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Rok vydání: | 2019 |
Předmět: |
Male
Microbiology (medical) Pediatrics medicine.medical_specialty Tuberculosis Antitubercular Agents Human immunodeficiency virus (HIV) medicine.disease_cause Tanzania 03 medical and health sciences 0302 clinical medicine Dar es salaam Latent Tuberculosis 030225 pediatrics Prevalence medicine Humans Prospective Studies 030212 general & internal medicine Child Prospective cohort study biology Latent tuberculosis Diagnostic Tests Routine business.industry Isoniazid Infant bacterial infections and mycoses biology.organism_classification medicine.disease Tb exposure Infectious Diseases Child Preschool Pediatrics Perinatology and Child Health Female business Interferon-gamma Release Tests medicine.drug |
Zdroj: | Pediatric Infectious Disease Journal. 38:333-339 |
ISSN: | 0891-3668 |
Popis: | Background Childhood tuberculosis (TB) is acquired after exposure to an infectious TB case, often within the household. We prospectively screened children 6-59 months of age, exposed and unexposed to an infectious TB case within the same household, for latent tuberculosis infection (LTBI), in Dar es Salaam, Tanzania. Methods We collected medical data and clinical specimens (to evaluate for helminths, TB and HIV coinfections) and performed physical examinations at enrollment and at 3-month and 6-month follow-up surveys. LTBI was assessed using QuantiFERON-TB Gold (QFT) at enrollment and at 3 months. Results In total, 301 children had complete data records (186 with TB exposure and 115 without known TB exposure). The median age of children was 26 months (range: 6-58); 52% were females, and 4 were HIV positive. Eight children (3%) developed TB during the 6-month follow-up. We found equal proportions of children with LTBI among those with and without exposure: 20% (38/186) versus 20% (23/115) QFT-positive, and 2% (4/186) versus 4% (5/115) indeterminate QFT. QFT conversion rate was 7% (22 children) and reversion 8% (25 children). Of the TB-exposed children, 72% initiated isoniazid preventive therapy, but 61% of parents/caregivers of children with unknown TB exposure and positive QFT refused isoniazid preventive therapy. Conclusions In this high burden TB setting, TB exposure from sources other than the household was equally important as household exposure. Nearly one third of eligible children did not receive isoniazid preventive therapy. Evaluation for LTBI in children remains an important strategy for controlling TB but should not be limited to children with documented TB exposure. |
Databáze: | OpenAIRE |
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